Deciding on and describing policy options to address a health system problem requires identifying potential options, finding evidence of the impacts of those options, appraising that evidence, and summarising what is known about the likely impacts of viable options. Systematic reviews should be used, as far as possible, as the basis for describing the likely impacts of included options. It is important to appraise both how much confidence can be placed in a review (this is related to how well the review was conducted), and how confident we can be about the likely impacts of the policy option based on the evidence that is reviewed. Evidence of the effect of health systems arrangements and implementation strategies is often limited, particularly from low- and middle-income countries, and decisions may therefore frequently need to be made based on evidence that is of low quality. Performing only a cursory review of the evidence may result in unreliable descriptions of policy options, a loss of credibility, biased assessments, and over or understatement of the degree of confidence that can be placed in estimates of effect or about the likely impacts of options. Consequently, the additional investment of doing a systematic and transparent review is likely to be warranted with respect to a particular policy brief, and to improving the extent to which health policy decisions are informed by the best available research evidence.
The following questions can be used to decide on and describe the
policy options that will be included in a policy brief:
Workshop materials and a PowerPoint presentation on deciding and describing the policy options are available in the ‘Additional resources’ section of this guide.